AIM: To evaluate the efficacy of vitreoretinal surgery in the treatment of X-linked retinoschisis(XLRS)and its complications.

METHODS: A retrospective study was made on all the XLRS patients with severe complications after operation in this hospital. All the 25 patients(31 eyes)present with macular abnormalities with/without peripheral retina split bypreoperative OCT examination. Among the 31 eyes, there were 7 eyes with vitreous hemorrhage, 8 eyes with retinal detachment and vitreous hemorrhage, and 16 eyes with rhegmatogenous retinal detachment. All the 31 eyes were divided into 2 groups: group A included 15 eyes which underwent photocoagulation before the surgery, while the other 16 eyes in group B didn't perform photocoagulation before the surgery. All the patients underwent a pars plana vitrectomy without lensectomy associated with internal limiting membrane peeling. Photocoagulation was done to the retinal holes and degeneration areas in group A. Gas or silicone oil was filled in group B after retinal photocoagulation treatment. Three years later, analysis was made on the results of the visual acuity, postoperative anatomical and functional outcome in these 2 groups. Statistical analysis was made on the results of average visual acuity before and after operation by SPSS software method, the difference was statistically significant(P<0.05). The differences of changes of visual acuity in two groups were statistically significant by one-way analysis of variance method.

RESULTS: Postoperative anatomical and functional outcome were satisfied at the last visit. A total of 23 eyes'(74.2%)visual acuity were improved with the mean visual acuity increasing from 0.13±0.08 to 0.24±0.16, the difference was statistically significant(t=-5.354,P=0.000). The average visual acuity in group A was improved from 0.11±0.08 to 0.22±0.15 after operation(t=-4.391, P=0.000). While the average visual acuity in group B increased from 0.14±0.08 to 0.26±0.15(t=-4.488, P=0.000). The visual changes in two groups were statistical significance. But when compared the average changes of visual acuity before and after operation between two groups, F=4.055, P=0.069, there was no statistical significance. During the following-up period, the complications were found in three eyes, among which two eyes presented with proliferative vitroretinopathy and traction retinal detachment 10 and 12 months after surgery, and one eye presented with cataract 3 months after surgery. Two eyes belonged to group A while the third eye pertain to group B. After reoperation, all the three eyes have good prognosis and retinoschisis didn't worsen.

CONCLUSION: Vitreoretinal surgery can be applied to the treatment of X-linked congenital retinoschisis and its complication, effectively preventing the deterioration of schisis cavity and contributing to the improvement and stabilization of visual acuity and resuming the anatomic structure of retina.